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General NPI Number Information
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NPI Number | 1093231367
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Entity Type | Individual
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Provider Name | WILNEISHA CHARRON JAKES LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 500 MADISON AVE STE 200
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City | TOLEDO
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State | OH
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Zip | 43604-1230
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Country | US
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Telephone | 567-312-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 3033 BARDIN RD APT 105
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-3859
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Country | US
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Telephone | 504-330-7340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 12377
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2512618
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12377
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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